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Artículos destacados

October

Interventions to Improve Hydration in Older Adults: A Systematic Review and Meta-Analysis

Bruno C, Collier A, Holyday M, Lambert K. Interventions to Improve Hydration in Older Adults: A Systematic Review and Meta-Analysis. Nutrients. 2021 Oct 18;13(10):3640. doi: 10.3390/nu13103640. PMID: 34684642; PMCID: PMC8537864.

Dehydration is common in the elderly, especially when hospitalised. This study investigated the impact of interventions to improve hydration in acutely unwell or institutionalised older adults for hydration and hydration linked events (constipation, falls, urinary tract infections) as well as patient satisfaction. Four databases were searched from inception to 13 May 2020 for studies of interventions to improve hydration. Nineteen studies (978 participants) were included and two studies (165 participants) were meta-analysed. Behavioural interventions were associated with a significant improvement in hydration. Environmental, multifaceted and nutritional interventions had mixed success. Meta-analysis indicated that groups receiving interventions to improve hydration consumed 300.93 mL more fluid per day than those in the usual care groups (95% CI: 289.27 mL, 312.59 mL; I2 = 0%, p < 0.00001). Overall, there is limited evidence describing interventions to improve hydration in acutely unwell or institutionalised older adults. Behavioural interventions appear promising. High-quality studies using validated rather than subjective methods of assessing hydration are needed to determine effective interventions.

Preoperative nutrition care in Enhanced Recovery After Surgery programs: are we missing an opportunity?

Martin L, Gillis C, Ljungqvist O. Preoperative nutrition care in Enhanced Recovery After Surgery programs: are we missing an opportunity? Curr Opin Clin Nutr Metab Care. 2021 Sep 1;24(5):453-463. doi: 10.1097/MCO.0000000000000779. PMID: 34155154.

Purpose of review: A key component of Enhanced Recovery After Surgery (ERAS) is the integration of nutrition care elements into the surgical pathway, recognizing that preoperative nutrition status affects outcomes of surgery and must be optimized for recovery. We reviewed the preoperative nutrition care recommendations included in ERAS Society guidelines for adults undergoing major surgery and their implementation.

New cancer cachexia staging system for use in clinical practice

Wiegert EVM, de Oliveira LC, Calixto-Lima L, Chaves GV, Silva Lopes MS, Peres WAF. New cancer cachexia staging system for use in clinical practice. Nutrition. 2021 Oct;90:111271. doi: 10.1016/j.nut.2021.111271. Epub 2021 Apr 11. Erratum in: Nutrition. 2021 Aug 3;:111410. PMID: 34004417.

Background : Previous attempts to classify cancer cachexia (CC) have demonstrated limitations regarding stages and diagnostic criteria. This study aims to develop and validate a new staging system for CC in incurable cancer patients.

Low skeletal muscle mass is a predictor of treatment related toxicity in oncologic patients

Surov A, Pech M, Gessner D, Mikusko M, Fischer T, Alter M, Wienke A. Low skeletal muscle mass is a predictor of treatment related toxicity in oncologic patients. A meta-analysis. Clin Nutr. 2021 Oct;40(10):5298-5310. doi: 10.1016/j.clnu.2021.08.023. Epub 2021 Sep 3. PMID: 34536638.

Background & aims: The purpose of this meta-analysis was to summarize the published data regarding associations between occurrence of severe treatment related toxicity and low skeletal muscle mass (LSMM) in oncologic patients and to perform a meta-analysis based on a large sample.

September

Meal-induced inflammation: postprandial insights from the Personalised REsponses to DIetary Composition Trial (PREDICT) study in 1000 participants

Mazidi M, Valdes AM, Ordovas JM, Hall WL, Pujol JC, Wolf J et al. Am J Clin Nutr. 2021 Sep 1;114(3):1028-1038. doi: 10.1093/ajcn/nqab132. PMID: 34100082; PMCID: PMC8408875.

Tras la ingesta, se desencadenan procesos metabólicos inflamatorios inducidos por la comida y que contribuyen a la inflamación crónica (I). Los factores implicados en este estado inflamatorio tras la ingesta dependerán de la frecuencia de las comidas (si son frecuentes será más prolongado),  la composición de la comida, el alcohol, la edad, el género, el IMC o la etnia.

En este trabajo -el mayor realizado hasta la fecha-  se realizaron  múltiples determinaciones  secuenciales tras ingesta de comida, de nutrientes mixtos, en 1002 adultos sanos de 18 a 65 años de edad. Se determinó, entre otros, un marcador inflamatorio tradicional como es la interleucina 6 (IL-6), un marcador emergente conocido como glicoproteínas de acetilación (GlycA), la glucemia postprandial, lipidograma y datos de composición corporal (DEXA). Su objetivo era cuantificar y predecir variaciones individuales en las respuestas metabólicas tras las comidas.  Se evidenciaron cifras más elevadas de GlyA en aquellos casos con mayor glucemia postprandial y de triglicéridos postprandiales;  siendo esta última variable, el predictor más importante de inflamación. La grasa visceral elevada, se asoció a mayor elevación triglicéridos en ayunas, y a una respuesta inflamatoria postprandial elevada.

Los resultados del estudio PREDICT sugieren que: las concentraciones postprandiales de GlycA proporcionan una mejor discriminación de la respuesta inflamatoria en relación con la ingesta; las  actuaciones dirigidas a reducir la  grasa visceral y de las concentraciones de triglicéridos séricos, reducen la carga inflamatoria, y que probablemente dietas, y nutrientes, que induzcan una menor elevación de la inflamación postprandial tendrán un papel fundamental en el manejo de patologías con un componente inflamatorio tales como por ejemplo la obesidad y la diabetes mellitus tipo 2.